Evidence map›Paper›PMID 39294517›Full record

ArticleThe patient2025

Exploring How Values of Colorectal Cancer Patients and their Caregivers Influence Treatment Decision-Making.

Raza M Mirza, Sabrin Salim, Jennifer A H Bell, Mary Jane Esplen, Karen V MacDonald, Barry D Stein, Deborah A Marshall

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Article in The patient, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Raza M MirzaInstitute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-4430-6012
Sabrin SalimMD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-7237-5651
Jennifer A H BellPrincess Margaret Cancer Center, University Health Network, Toronto, ON, Canada.ORCID 0000-0003-2712-4583
Mary Jane EsplenDepartment of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6034-2235
Karen V MacDonaldDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Health Research Innovation Centre (HRIC) Building, Room 3C58, Calgary, AB, T2N 4Z6, Canada.ORCID 0000-0001-7739-4296
Barry D SteinColorectal Cancer Canada, Montreal, QC, Canada.ORCID 0009-0007-3048-5124
Deborah A MarshallDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Health Research Innovation Centre (HRIC) Building, Room 3C58, Calgary, AB, T2N 4Z6, Canada. damarsha@ucalgary.ca.ORCID 0000-0002-8467-8008

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs we adopt value models to inform drug reimbursement, coverage, clinical trials, and treatment choices, aligning these models to reflect patient values and preferences becomes increasingly relevant. In this study, we focus on colorectal cancer (CRC), which is highly prevalent and a leading cause of death in Canada, and new drug treatment options are costly.

objectiveThe aim of this study was to understand how the values and experiences of people with CRC and their caregivers inform their perspectives about new and emerging colorectal cancer drug treatments.

methodsWe applied qualitative methods to identify key personal, social, and system factors about how the values of people with CRC and their caregivers' values influence their treatment decision-making in a more holistic manner. Canadian adults (>18 years) living with non-metastatic or metastatic CRC and caregivers were recruited from oncology clinics and Colorectal Cancer Canada (CCC) using purposive sampling. Participants engaged in structured interviews by telephone. Interviews were transcribed verbatim and analyzed thematically guided by a qualitative phenomenological approach and Sherwin's ethical theory of relational autonomy using NVivo software.

resultsWe conducted structured interviews with 12 people with CRC and six of their caregivers, and elicited patient and caregiver values and their influence on treatment decision-making context of key personal, social, and system factors. Thematic analysis of transcripts led to the development of four overarching and intersecting themes that were identified as influencing people with CRC and their caregivers' treatment decision-making: treatment outcomes and effectiveness, intrapersonal and interpersonal factors, quality of life, and survivorship and prognosis. DISCUSSION: Our findings suggest intersecting influences of patient-, community-, and social network-, and systemic-level factors that influence patients' decisions on treatment. Perceived clinical benefit, requirements of treatment, available information, the impact of treatment on social relationships and daily life, and the impact of social support were key factors described by participants. To our knowledge, this is the first study to utilize the theory of relational autonomy to understand patient and caregiver values in the context of treatment decisions in CRC. Using these findings, a continued exploration of people with CRC's values in treatment decision-making and how much patients value or weight the different aspects of treatment would help further advance patient care and guide healthcare system decision-making.

Indexed as

CaregiversColorectal NeoplasmsDecision MakingAdultAgedAged, 80 and overCanadaFemaleHumansInterviews as TopicMaleMiddle AgedPatient PreferenceQualitative Research

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.